23-week-old male presented to the ED with increased swelling | Figure 1

23-week-old male presented to the ED with increased swelling of his sixth digit, classified as postaxial polydactyly type B (PAPB). Mother reported that the patient often used the digit for teething and his siblings also “played with it,” which caused excessive twisting and ultimately compromised proper circulation.

Patient was born a healthy, full-term baby and has no other medical history. Mother reported that although she did not have polydactyly, both her father and sister had PAPB with successful removal as infants. Postaxial polydactyly type B has been proven to be caused by a genetic mutation in the GLI3 gene which was allegedly found in her sister’s DNA.

Mother stated that the PCP had referred them to plastic surgery with no success in reaching treatment options. The ED physician successfully excised the extra digit with no complications. Standard follow-up and wound care instructions were given upon discharge.

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